Before setting up claims you must make sure you have added your claimant number to RxOne. You can do this in the Options window. Claims will not be successful until this is done.

Open

Options > User Details

1 Introduction

1.1 Purpose of the Document

The purpose of this document is to communicate the steps involved for the installation of Pharmacy Claiming for HealthSoft Pharmacy Management Software (PMS) users.  For Pharmacy claiming to be installed on the designated computer at your pharmacy and function securely there are some activities you are required to perform.  This document provides a step by step guide on how to complete the required steps to ensure you can begin submitting your pharmacy claims online.

1.2 Check Requirements

Before you begin please make sure you have the following accessible:

• Digital Certificate and Security password2.

• Online Claiming Username and password (provided by the Ministry of Health through email)

1.2.1 Check for Windows Updates (To be done on all computers in the shop)

Go to the RxOne Start Menu; from the top menu select Help, About SystemThe ‘System details’ report will openCheck ‘Windows Updates” – left hand side, 4th row‘Daily 3am’ is the default setting time for updates to run (you will need to ensure computers are left on overnight).If you prefer updates to run at a different time or Windows Updates says ‘False’, please phone HealthSoft for assistance (Phone 09 3007007).

2 HealthSecure Digital Certificate

• Open the RxOne Dispensary

• Open SmartClaim, click on Options and select 'Install Online Claims': Select Yes to export the certificates and set up MoH Messenger now. Enter your HealthLink Digital Certificate Password. Re-Enter your HealthLink Digital Certificate Password. You will be asked to put your HealthLink disk into the CD Drive on this computer(Please contact HealthLink on 0800 288 887 to obtain a Digital Certificate CD if you don't have one)  The java engine will install.

• The MoH Messenger will install.

• You will then see the following message

  •  Online Claims now Installed. Are you replacing an existing computer?

    • If you click No then the following message will show and the Delegate Authority Web page will be opened: "You now need to update the MoH Delegate Authority. If you have your Delegate Authority User Name and Password please follow the instructions on the web page. Otherwise please call the Online Claiming Help Desk on 0800 505 125 Option 3"

• When you go into RxOne on any other computer the certificates will be updated on that machine and Online Claims will be automatically installed on that machine

3 Uploading the Digital Certificate

3.1 Uploading the Public Key into the Delegated Administration (DA) Tool

Before uploading your digital certificate, The Ministry of Health needs to register your pharmacy as a business party inside the Delegated Administration system.

After registration, The Ministry of Health will issue you with the details of an admin user account for your pharmacy. This account will enable you to log in to the Delegated Administration service and then upload your digital certificate.

Please make sure you have been notified of your user account by the Ministry of Health before proceeding.

Open Windows Internet Explorer  Browse to https://10.247.213.22/da The Browser Security Check message is displayed after entering the DA Tool web address?  Click on the link saying Continue to this website.  Do not be concerned if you do not receive this message, your browser is simply configured to have fewer restrictions on web content. 

Enter your User Name and Password provided to you by the MoH, and click on Login.

Click on the ‘Organisations’ header – this will bring up a list of organisations to which you belong:

Select your claimant number

On the Certificates tab, scroll down then click on Upload

Browse to your digital certificate (your Claimant number.cer eg: 3000.cer) saved earlier in the folder C:\Workspace\Certs, and Select Open

Then click on Apply Changes.

When you receive the message Operation is completed successfully, click on OK.To verify the digital certificate has uploaded successfully, you can check by clicking on your Claimant Number and you should see the digital certificate in the Manage Certs screen.Click on Logout and select Yes.Your Digital Certificate may not be required for some time.  Please store the CD in a secure location, so you can access in the future if required.

4 Online Claiming

You are now ready to begin claiming online.  If the frequency you can submit claims has changed via your Pharmacy Services Agreement variation with your DHB, there is one more step required to be completed after you have submitted your first online claim.

4.1 Update to Four Times a Month Claiming

The first online claim you submit will be a fortnightly claim.  After you have successfully submitted your first online claim, and if you have an agreement variation to submit claims four times a month, please follow the below steps.

From the RxOne Start Menu open SmartClaim and click on Options

Select Default Claim Date and change from Twice Monthly to Weekly.

5 Appendix A: Maintenance of Digital Certificates

5.1 Renewal of Digital Certificates

HealthSecure Digital Certificates are valid for 12 months.  When the digital certificates expiry date is approaching, you should receive a letter from the Registration Authority six weeks prior to your certificate expiry.  Once you have returned your renewal forms, HealthLink should provide you with your replacement digital certificate.

When you receive your replacement digital certificate, the following will need to be updated:

• Internet Explorer Certificate Store

• Private and Public Key

• MoH Messenger

• Delegated Administration Tool

5.1.1  Internet Explorer Certificate Store

Complete steps to renew digital certificate provided by HealthLink

5.1.2 Replace Digital Certificate in MoH Messenger

Instructions to update the HealthLink Certificate.

You should have already received a CD from HealthLink.

• Insert the HealthLink CD into the drive on your master computer

• CANCEL the Autoplay (very important)

• From the RxOne Start Menu go to SmartClaim

• Double-click on the ‘Install Online Claims’ button

  • Say ‘Yes’ to the question ‘Do you want to export the certificates and set up MoH Messenger now?’

  • Follow the prompts to complete the install, e.g. type in password exactly as supplied (will need to do this twice)

  • You will need to contact the MoH Sector Services to have them install the Delegate Authority (0800 505 125  Option 3)

5.1.3 Uploading the Public Key into the DA Tool

Refer to the steps detailed in 3.1 of this document

5.2 Deleting Digital Certificates – e.g. Certificate Holding Staff Member leaves

If a person holding a HealthSecure digital certificate leaves the pharmacy, their certificate should be deleted from the C:\Workspace\Certs, MoH Messenger and DA Tool and a new one for an existing staff member should be loaded.  However to avoid any interruption with the submission of claims, do not delete the existing digital certificate until you are ready to load the new digital certificate.

To delete a digital certificate for a user follow the steps provided above in 5.1 Renewal of Digital Certificates.

5.3 Change of Ownership or Pharmacy Restructure

Due to the number of complex scenarios occurring in this area, it is difficult to accurately detail generic steps.  Direct contact with the Pharmacy is required to ensure instructions are provided.  Please contact HealthSoft on 09 357 6701 and the Ministry of Health, Sector Services 0800 505 125 as early as possible prior the change occurring to ensure the transition occurs as smoothly as possible.

5.4 Support for Multiple Claimants

This section will only be applicable to pharmacies required to operate more than one Claimant Number concurrently.  This situation can occur if you operate a pharmacy chain where all claims are processed at a single location or if you are undergoing a change of ownership and the claim periods for the old and new claimants overlap.

6 Appendix B: Useful Information

6.1 Contact Details

HealthSoft: 09 3007007 Initial point of contact for: • claim transmission errors• program errors• claiming set up issues

Ministry of Health (Sector Services) : 0800 505 125 Option 3

Initial point of contact for:• Online set up and ongoing support• Start date of first online claim• Access Manager login issues• Claim response generation issues• Claim reimbursement details

HealthLink: 0800 288 887

Initial point of contact for:• Digital Certificate queries 6.2 Claiming Periods

Four Times a Month Claiming

Fortnightly Claiming

• Due date means the fourth business day following the Claim Period to which the claim in question relates.

• Where the Payment Date is not a Business Day, then the Payment Date will be made on the first Business Day following the Payment Date.

7. Appendix C 

7.1 Acronyms and definitions used in this document 

Acronym Description 

Claim Period

The claim period is the end date of the period being claimed and should always be one of the following dates, dependent on the agreement held between the DHB and the Service Provider. 

Fortnightly claiming agreement– 15th or last day of the month 

Weekly claiming agreement– 7th, 15th, 23rd or last day of the month 

DA Tool -Delegated Administration Tool 

Digital Certificate- Digital Certificates serves as a virtual identity for a company or individual transmitting information across the internet. Digital Certificates are issued by an outside Certificate Authority and are by a recipient to verify electronic information comes from a safe source. 

HealthLink Issuers of Digital Certificates for Online claiming. 

MoH Ministry of Health 

MoH Messenger The MoH Messenger application is a secure courier service working with the Practice Management System for online claiming. 

OPC Online Pharmacy Claiming 

Private Key A private, or secret key, is an encryption/decryption key known only to the party or parties exchanging secret messages. In this system, a public key is used together with a private key.  These are parts of your digital certificate 

Public Key A public key certificate (also known as a digital certificate or identity certificate) is an electronic document using a digital signature to bind together a public key with an identity. Information contained on a certificate can be the name of a person or an organization and their address. The certificate can be used to verify a public key belongs to an individual. These are parts of your digital certificate 

RIM Role-based Identity Manager 

Sector Support A Ministry of Health team within Sector Services, their key role is to process claims, and applications, and provide Contact Centre Support for Service Providers.